Five Financial Lessons From New York's COVID Hotspot

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Executives discuss the COVID-19 financial fallout and what future subsequent peaks might look like for health systems.

HealthLeaders

Editor's Note: The following is part of an ongoing series offering our strategic advice and expertise on what healthcare industry stakeholders should do immediately in response to the rapidly evolving novel coronavirus (COVID-19) pandemic. The below is a summary of a recent article from HealthLeaders who covered the webinar panel that Oliver Wyman co-hosted with OODA Health in May called "At the Front Line of COVID-19: How Leading Health Systems and Payers are Addressing Severe Financial and Operational Risks," featuring executives from Northwell Health, OODA Health, and Empire BlueCross BlueShield, Inc.

2020 has been a year of havoc and financial fallout. Building hospitals in the middle of open fields, for example, wasn't something on most hospitals' radars until recently.

New York, namely New York City, has taken the brunt of COVID-19's substantial impact in the US and has essentially been the nation's epicenter of coronavirus. 

Northwell Health's chief business strategy officer stated that although things are looking better, they are not out of the woods yet. This health system, the largest provider in New York, has already treated an estimated 40,000 COVID-positive patients. 

As various parts of the nation from NYC, the NYC Tri-state area, and beyond continue managing this ongoing pandemic, the panelists shared five specific lessons that health system financial leaders should consider:

1. Plan ahead to redeploy the staff behind your revenue cycle. Said Rich Miller, Northwell Health's Executive Vice President and Chief Business Strategy Officer, thousands of his colleagues, including those with a blend of both revenue cycle and clinical backgrounds, were redeployed back into the medical field after COVID-19 began. This all-hands-on-deck approach includes preparing for all employees (not only doctors and nurses, but also those on the revenue cycle, for instance) to potentially become ill with COVID-19. Over 100 front-line revenue cycle staff, he said, have tested positive for COVID-19 so far. This has made redeployment all the more challenging, he emphasized.

2. Prepare for patients to stay for a long time. Added Miller, Northwell has seen an influx of COVID-19 patients, who stay three or four times as long compared to typical med-surg patients. Significant costs are being generated as a result, he said. They've made some creative switches to help ease the burden. But there are other big restrictions across the area like those regarding elective procedure postponement. In the meantime, some parts of New York state have begun to open their elective and endoscopy procedures.

3. Acknowledge that routine processes will involve more effort and more time. The many facets to caring for COVID-19 patients include revenue cycle, freezing patients' bills until insurance has kicked in, and the like. Northwell, for instance, stopped point-of-sale collections and held patients' bills in this manner, said Miller. Payer configuration of systems, he said, proved very hard, emphasizing the importance of a cost-sharing balance for patients.

4. Move with agility in the right direction before chaos ensues. Said Northwell, its revenue cycle workers operated remotely, and quickly so, amidst the evolving pandemic. Another factor, he said, was there was hazardous weather in the region of their workplace. Yet, things churned on as normal. Adding value in this way, he said, will be what "the new normal" really becomes defined as in time.

5. Know that big changes are necessary and that some big changes will endure long-term. Telehealth, said Gerard Brogan, MD, Northwell's Senior Vice President and Chief Revenue Officer, involves a permanent shift in care delivery amidst COVID-19. Northwell is specifically switching up its physical spaces, from adding plexiglass barriers to staffing folks with more protective gear.

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